A Comparative Study of Epidural, Bupivacaine with Butorphanol and Bupivacaine with Fentanyl In Lower Limb Surgeries
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 3
Abstract
Introduction: Intrathecal anesthesia and epidural anesthesia (EA) are the most popular regional anesthesia techniques used for surgeries below umbilicus. EA is more versatile in providing anesthesia, analgesia and treatment of chronic disease syndromes. It provides better postoperative pain control and more rapid recovery from surgery. It also provides effective prolonged surgical anesthesia, prolonged postoperative analgesia, reduces the incidence of hemodynamic changes and reduces the incidence of PDPH as the dura is not pierced. Aims And Objectives: To Compare with the efficacy of lumbar epidural block with 0.5% bupivacaine 10ml with Fentanyl 50µg and 0.5%bupivacaine 10ml with butorphanol 1mg in lower limb surgeries focusing on Onset and duration of analgesia, Cardio respiratory effects, Sedation, Adverse effects Summary: The study was conducted to compare the effect in lower limb surgeries. 100 patients belonging to ASA grade I&II were selected. Bupivacaine (0.5%) 10ml with fentanyl (50µg) was given in Group I, and Bupivacaine (0.5%)10ml with butorphanol (1mg) was given in Group II. The patients studied across the group did not vary much with respect to age, sex or height. The onset of sensory blockade was delayed by about 20 seconds in groupII and the onset of motor blockade was delayed by about 20- 25 seconds in group-II compared to group-I. Duration of sensory blockade in Group II is longer compared to group I , thus prolonging the duration of analgesia. Duration of motor blockade in group II is prolonged than in Group I . The time of first request of analgesics by the patients in group-II is longer (360 minutes) compared to group-l (206 minutes) thus prolonging the duration of analgesia. Visual analogue scores were significantly lower in group-II compared to group-l thus reducing the requirement of supplemental postoperative analgesics. The adverse effects observed in the study were minimal. Conclusion: Addition of the opioids, i.e., Butorphanol and Fentanyl significantly quickens the onset and prolongs analgesia Onset is fast with Bupivacaine with Fentanyl combination compared with Bupivacaine with Butorphanol combination . Bupivacaine with Butorphanol provide more effective and longer duration of analgesia as compared with Bupivacaine with Fentanyl.
Authors and Affiliations
Dr. P. Nageswararao, Dr. B. Venugopalan, Dr. S. Seetharamaiah
Keywords
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- EP ID EP369799
- DOI 10.9790/0853-1703134956.
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